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Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients

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Added on  2020-02-24

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In such situation, radiation therapy is regarded as a targeted treatment option to kill or reduce the number of those cancer cells, which may remain even after surgery (McGale et al., 2014). This is linked to the high amount of radiation exposure to lungs and heart during radiation therapy and a technique was needed that reduced the exposure rate to the lungs and heart of breast cancer patient (Taylor et al.

Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients

   Added on 2020-02-24

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Running head: LITERATURE REVIEWLiterature reviewName of the student:Name of the UniversityAuthor’s note
Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients_1
1LITERATURE REVIEWTable of contents Table of ContentsIntroduction:....................................................................................................................................2Methods:..........................................................................................................................................4Literature review:.............................................................................................................................4Advantage of DIBH related to patient outcome and compliance with the procedure.....................7Discussion:.....................................................................................................................................10Conclusion:....................................................................................................................................11References......................................................................................................................................12
Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients_2
2LITERATURE REVIEWIntroduction: Mastectomy does not guarantee complete cure for early breast cancerpatients; instead it increases the chance of recurrence because some tumormight remain in the chest wall. In such situation, radiation therapy isregarded as a targeted treatment option to kill or reduce the number ofthose cancer cells, which may remain even after surgery (McGale et al.,2014). External radiation therapy is most commonly given to patients aftermastectomy. However, respiratory motion has been found to cause severeerror during the radiation therapy. Respiratory motion leads to displacementof the tumour location and localizing the tumor in the chest wall becomesdifficult in such cases. Another issue is that respiratory motion duringirradiation leads to overdosing of normal tissues and underdosing of thetumor tissue or cells (Lewis & Jiang, 2009). One report gives evidenceregarding the issues in patient after the breast cancer radiotherapy. Link wasfound between radiation therapy and high risk of breast cancer and lungproblems. The study was done with 40, 781 women diagnosed with earlystage breast cancer and they randomly assigned to radiation therapy andsurgery or surgery alone. The follow up study after 10 years revealed that20, 345 women died and the other 6, 064 had no breast cancer recurrence.However, compared to women treated without radiation therapy, womenwith radiation therapy were most likely to be diagnosed with lung cancer andheart disease. This is linked to the high amount of radiation exposure tolungs and heart during radiation therapy and a technique was needed that
Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients_3
3LITERATURE REVIEWreduced the exposure rate to the lungs and heart of breast cancer patient(Taylor et al. 2017).Use of deep inspiration breath hold (DIBH) has been recognized as atechnique to minimize irradiation of cardiac structures without compromisingtarget coverage. Although no clinical studies has demonstrated theeffectiveness of the technique in reducing morbidity, however it has beenfound to decrease dose to cardiac structure. In case of left sided breastcancer patient, the mean heart dose should not be greater than 4Gy (Yeunget al., 2015). Hence, adjusting dose limit through DIBH minimizes the risk ofischemic heart disease due to radiotherapy.Respiratory movement always remain a challenge in radiotherapy. Lotof research has been done to develop a technique that reduce the dose ofradiation to normal cell (heart dose) in breast cancer patients (Giraud &Houle, 2013). To control the effects of respiratory motion duringradiotherapy, the respiratory gating technique has been regarded as asolution to protecting the normal cells and managing respiratory motion.These techniques used five techniques to mitigate the respiratory motioneffects. This includes using breath hold technique, forced shallow breathingtechnique, respiratory gating technique and tracking techniques. The mainadvantage of integrating respiratory movement into treatment planning isthat it leads to geometric precision and dosimetric improvements (Giraud &Houle, 2013).
Advantage of mastectomy: a novel approach to improve outcomes in early breast cancer patients_4

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